title: Plasma P-selectin predicts long-term cardiovascular events in hospitalized patients with suspected coronary artery disease and preserved left ventricular function: a 10-year follow-up study.
abstract: BACKGROUND
  A variety of biomarkers have been investigated on their values to predict cardiovascular outcomes, such as high-sensitivity C-reactive protein (hs-CRP), fibrinogen, troponin-I (TnI), and soluble P-selectin (sP-sel). By a design of head-to-head comparison, this study sought to figure out the long-term prognostic values of these parameters in patients hospitalized with suspected coronary artery disease.
  
  
  METHODS
  A total of 170 patients hospitalized with suspected coronary artery disease were enrolled and followed up for an average of 10 years. sP-sel, hs-CRP, TnI, and fibrinogen levels were measured. During the follow-up period, cardiac events were recorded including cardiac death, non-fatal myocardial infarction, and acute coronary syndromes with hospitalization.
  
  
  RESULTS
  For all 170 patients, with a median follow-up time of 9.86 ± 3.87 years, no parameter was able to significantly predict the occurrence of cardiac events. In subgroup analysis, an sP-sel of ≥ 63.5 ng/ml significantly predicted the development of all composite cardiac events only in patients with a left ventricular ejection fraction > 50% (n = 94, p = 0.04). However, the levels of hs-CRP, TnI, and fibrinogen did not have significant predictive values. Multivariate analysis also demonstrated the independent predictive value of sP-sel on all cardiac events (hazard ratio = 5.82, p = 0.02). All parameters, including sP-sel, could not demonstrate prognostic values in patients with a left ventricular ejection fraction ≤ 50% (n = 76).
  
  
  CONCLUSIONS
  In this 10-year long-term follow-up study, sP-sel was demonstrated to have prognostic values in predicting the cardiac events in patients with preserved left ventricular systolic function.
authors.affiliation: Department of Internal Medicine, Heart Failure Center, Division of Cardiology, Chang Gung Memorial Hospital at Keelung, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Wei-Siang
authors.initials: WS
authors.lastname: Chen
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Chen-Chin
authors.initials: CC
authors.lastname: Lee
authors.forename: Wen-Jin
authors.initials: WJ
authors.lastname: Cherng
authors.forename: Min-Hui
authors.initials: MH
authors.lastname: Liu
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003324:Coronary Artery Disease / Q000097:blood* / Q000503:physiopathology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D019007:P-Selectin; D005340:Fibrinogen; D002097:C-Reactive Protein